Organization
WYANDOTTE MEDICAL PRACTICE
Active
Other names
Northline Womans Health
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BUDD (ADMINISTRATOR OUTPATIENT SERVICES)
(734) 246-8803
Entity
Organization
Contact information
Practice address
15675 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 282-3600
(734) 282-3603
Mailing address
15675 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 282-3600
(734) 282-3603
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
12/28/2010
Last updated
09/30/2011
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